Selected Abstracts

New developments in our understanding of acne pathogenesis and treatment

EXPERIMENTAL DERMATOLOGY, Issue 10 2009Ichiro Kurokawa
Abstract:, Interest in sebaceous gland physiology and its diseases is rapidly increasing.
We provide a summarized update of the current knowledge of the pathobiology of acne vulgaris and new treatment concepts that have emerged in the last 3 years (2005,2008).
We have tried to answer questions arising from the exploration of sebaceous gland biology, hormonal factors, hyperkeratinization, role of bacteria, sebum, nutrition, cytokines and toll-like receptors (TLRs).
Sebaceous glands play an important role as active participants in the innate immunity of the skin.
They produce neuropeptides, excrete antimicrobial peptides and exhibit characteristics of stem cells.
Androgens affect sebocytes and infundibular keratinocytes in a complex manner influencing cellular differentiation, proliferation, lipogenesis and comedogenesis.
Retention hyperkeratosis in closed comedones and inflammatory papules is attributable to a disorder of terminal keratinocyte differentiation.
Propionibacterium acnes, by acting on TLR-2, may stimulate the secretion of cytokines, such as interleukin (IL)-6 and IL-8 by follicular keratinocytes and IL-8 and -12 in macrophages, giving rise to inflammation.
Certain P. acnes species may induce an immunological reaction by stimulating the production of sebocyte and keratinocyte antimicrobial peptides, which play an important role in the innate immunity of the follicle.
Qualitative changes of sebum lipids induce alteration of keratinocyte differentiation and induce IL-1 secretion, contributing to the development of follicular hyperkeratosis.
High glycemic load food and milk may induce increased tissue levels of 5,-dihydrotestosterone.
These new aspects of acne pathogenesis lead to the considerations of possible customized therapeutic regimens.
Current research is expected to lead to innovative treatments in the near future.
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Frontiers in sebaceous gland biology and pathology

EXPERIMENTAL DERMATOLOGY, Issue 6 2008Christos C. Zouboulis
Abstract:, The development of experimental models for the in vitro study of human sebaceous gland turned down the theory of a phylogenetic relict and led to the identification of several, unknown or disregarded functions of this organ.
Such functions are the production of foetal vernix caseosa, the influence of three-dimensional organization of the skin surface lipids and the integrity of skin barrier and the influence on follicular differentiation.
In addition, the sebaceous gland contributes to the transport of fat-soluble antioxidants from and to the skin surface, the natural photoprotection, the pro- and antiinflammatory skin properties and to the innate antimicrobial activity of the skin.
It is mainly responsible for skin's independent endocrine function, the hormonally induced skin ageing process, the steroidogenic function of the skin as well as its thermoregulatory and repelling properties and for selective control of the hormonal and xenobiotical actions of the skin.
Interestingly, sebocytes, at least in vitro, preserve characteristics of stem-like cells despite their programming for terminal differentiation.
This review reports on various sebaceous gland functions, which are currently under investigation, including its role on the hypothalamus,pituitary,adrenal-like axis of the skin, the impact of acetylcholine on sebocyte biology, the activity of ectopeptidases as new targets to regulate sebocyte function, the effects of vitamin D on human sebocytes, the expression of retinoid metabolizing cytochrome P450 enzymes and the possible role of sebum as vehicle of fragrances.
These multiple homeostatic functions award the sebaceous gland the role ,brain of the skin' and the most important cutaneous endocrine gland.
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INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 4 2010Ichiro Kurokawa MD
Background, The histogenesis of nevus sebaceous (NS) is unclear.
Methods, To elucidate the histogenesis of NS, cytokeratin (CK) profiles were examined immunohistochemically using 10 anti-keratin antibodies in the three stages of NS.
Results, In the first stage, stratified differentiated keratins (CK1 and 10) were reduced, and basal keratin (CK14) was increased in the epidermis and primitive follicular structure (PFS).
In the second stage, in addition to reduced CK1 and CK10 expressions and increased CK14 expression, CK17 expression was strongly expressed in the sebaceous ducts in proportion to the development of sebaceous gland.
In the third stage, CK14, CK17 and CK19 were expressed in secondary tumors.
CK16 was not detected throughout all stages of NS.
Conclusion, These results suggest that NS is not hyperproliferative but involves hamartomatous differentiation with undifferentiated keratins.
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Ectopic sebaceous gland: a developmental anomaly

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 7 2006Jaime A. Tschen
This is an incidental finding in one of two biopsies from his chin, performed as part of the workup for a recalcitrant perioral acneiform eruption.
The embryogenesis and development of sebaceous glands in human scalp hair follicles are reviewed.
To our knowledge, this is the first report of such a developmental anomaly.
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Insights from the asebia mouse: a molecular sebaceous gland defect leading to cicatricial alopecia

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 9 2001K. S. Stenn
The primary cicatricial alopecias have proven to be challenging for the clinician, dermatopathologist and the researcher , let alone the patient.
If we are to improve our diagnostic and therapeutic tools for these very difficult disorders, we will need greater insight into their etiology.
Recent work with the mouse mutant, asebia, provides a model for cicatricial alopecia.
In this model the pathology , perifollicular inflammation, sebaceous gland "destruction", hair shaft granuloma, and cicatricial follicle drop-out , results from the mutation of one very important sebaceous gland gene.
In the absence of this gene, the sebaceous gland is hypoplastic and normal sebum production is minimal to absent.
In this paper the relevance of this mutant to human alopecias is discussed and the point emphasized that the pathogenesis of some forms of human cicatricial alopecia could involve the sebaceous gland.
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5-Aminolevulinic Acid Photodynamic Therapy: Where We Have Been and Where We Are Going

DERMATOLOGIC SURGERY, Issue 8 2004Michael H. Gold MD
Background.
Photodynamic therapy, utilizing the topical administration of 20% 5-aminolevulinic acid, has generated a great deal of interest in the dermatology community over the past several years.
Objective.
The purpose of this article is to review the history of photodynamic therapy in dermatology and to review recent new advances with this technology that will increase its appeal to all dermatologists.
Methods.
A literature review and results of new clinical trials with regards to photorejuvenation and acne vulgaris treatments with 5-aminolevulinic acid photodynamic therapy are presented.
Results.
Short-contact, full-face 5-aminolevulinic acid photodynamic therapy treatments with a variety of lasers and light sources have shown to be successful in treating all facets of photorejuvenation and the associated actinic keratoses as well as disorders of sebaceous glands, including acne vulgaris.
The treatments are relatively pain-free, efficacious, and safe.
They are also making already available laser/light source therapies work better for acne vulgaris and photorejuvenation.
Conclusions.
The use of 5-aminolevulinic acid photodynamic therapy with short-contact, full-face broad-application therapy is now able to bridge the world of medical and cosmetic dermatologic surgery.
This therapy is available for all dermatologists to utilize in the care of their patients.
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Clinical presentations of alopecia areata

DERMATOLOGIC THERAPY, Issue 4 2001Maria K. Hordinsky
Alopecia areata (AA) may can occur on any hair-bearing region.
Patients can develop patchy nonscarring hair loss or extensive loss of all body hair.
Hair loss may fluctuate.
Some patients experience recurrent hair loss followed by hair regrowth, whereas others may only develop a single patch of hair loss, never to see the disease again.
Still others experience extensive loss of body hair.
The heterogeneity of clinical presentations has led investigators conducting clinical therapeutic trials to typically group patients into three major groups, those with extensive scalp hair loss [alopecia totalis (AT)], extensive body hair loss [alopecia universalis (AU)], or patchy disease (AA).
Treatment outcomes have been correlated with disease duration and extent.
Recently, guidelines were established for selecting and assessing subjects for both clinical and laboratory studies of AA, thereby facilitating collaboration, comparison of data, and the sharing of patient-derived tissue.
For reporting purposes the terms AT and AU, though still used are defined very narrowly.
AT is 100% terminal scalp hair loss without any body hair loss and AU is 100% terminal scalp hair and body loss.
AT/AU is the term now recommended to define the presence of AT with variable amounts of body hair loss.
In this report the term AA will be used broadly to encompass the many presentations of this disease.
Development of AA may occur with changes in other ectodermal-derived structures such as fingernails and toenails.
Some investigators have also suggested that other ectodermal-derived appendages as sebaceous glands and sweat glands may be affected in patients experiencing AA.
Whether or not function of these glands is truly impaired remains to be confirmed.
Many patients who develop patchy or extensive AA complain of changes in cutaneous sensation, that is, burning, itching, tingling, with the development of their disease.
Similar symptoms may occur with hair regrowth.
The potential involvement of the nervous system in AA has led to morphologic investigations of the peripheral nervous system as well as analysis of circulating neuropeptide levels.
In this article the clinical presentations of AA are reviewed.
The guidelines for conducting treatment studies of AA are presented and observations on changes in cutaneous innervation are introduced.
Throughout the text, unless otherwise noted, AA will be used in a general way to denote the spectrum of this disease.
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Osteoderm morphology in recent and fossil euphractine xenarthrans

ACTA ZOOLOGICA, Issue 4 2009C. M. Krmpotic
Abstract
The presence of osteoderms within the integument, forming a carapace, is one of the most distinctive features of armadillos with the external morphology of these elements forming the basis of most systematic schemes.
This is especially true for fossil taxa, where these elements are most frequent in the palaeontological record.
A detailed study of osteoderms from the cephalic shield and different regions of the dorsal armour of Chaetophractus villosus (Euphractinae, Xenarthra) was made and compared to those of the extant genus Dasypus (Dasypodinae, Xenarthra), and the extinct genus ,Eutatus.
Three distinct histological zones were recognized: outer and inner zones are thin, formed by regular compact bone, the middle zone is thicker, with large cavities that contain mainly adipose tissue, hair follicles, and sweat and sebaceous glands.
The internal structure of ,Eutatus (also a member of Euphractinae) osteoderms is close to that of C. villosus, consistent with the notion that these taxa are phylogenetically closely related.
In contrast, Dasypus shows marked differences.
Dasypus shows hair follicles associated with both gland types (sweat and sebaceous) and connected to foramina on the external surface.
Although not observed in adult C. villosus, it has been documented during embryonic development, only to atrophy later in ontogeny.
Furthermore, the presence of red bone marrow is rare in C. villosus, but widespread in Dasypus novemcinctus osteoderms.
These results suggest an early split of both subfamilies and support the hypothesis that the Euphractinae are more derived than the Dasypodinae.
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Sweat gland epithelial and myoepithelial cells are vitamin D targets

EXPERIMENTAL DERMATOLOGY, Issue 2 2007Nobuo Koike
Abstract:, Nuclear receptor binding of 1,25(OH)2 -vitamin D3 (vitamin D) in skin keratinocytes of epidermis, hair sheaths and sebaceous glands was discovered through receptor microscopic autoradiography.
Extended experiments with 3H-1,25(OH)2 -vitamin D3 and its analog 3H-oxacalcitriol (OCT) now demonstrate nuclear receptor binding in sweat gland epithelium of secretory coils and ducts as well as in myoepithelial cells, as studied in paws of nude mice after i.v. injection.
The results suggest genomic regulation of cell proliferation and differentiation, as well as of secretory and excretory functions, indicating potential therapies for impaired secretion as in hypohidrosis of aged and diseased skin.
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Expression pattern of somatostatin receptor subtypes 1,5 in human skin: an immunohistochemical study of healthy subjects and patients with psoriasis or atopic dermatitis

EXPERIMENTAL DERMATOLOGY, Issue 12 2006Lena Hagströmer
Abstract:, In psoriasis and atopic dermatitis, the inflammatory events have neurogenic components and the neuropeptides modify the functions of immuno-active cells in the skin.
Somatostatin is a neuropeptide with several neuroendocrine and immunomodulating properties and mediates its actions by five distinct subtypes of G-protein-coupled receptors (SSTR1-5).
This study describes the distribution of SSTR1,5, analysed with immunohistochemistry, in psoriasis, atopic dermatitis and controls.
Normal human skin and lesional skin from patients with psoriasis or atopic dermatitis showed many similarities, but also some differences, as regards SSTR expression.
SSTR1,3 were strongly expressed in the epidermis of healthy skin, and in the skin of patients with psoriasis or atopic dermatitis.
It is noteworthy that SSTR4 and 5 were strongly expressed in the epidermis of psoriasis patients, but weakly expressed in the epidermis of those with atopic dermatitis and normal skin.
The intensity of the staining also varied considerably between the different layers of the epidermis, especially in psoriasis patients.
In all cases, the dendritic cells, found mostly in the papillary and upper reticular dermis, showed a strong expression of SSTR1,4, but a weak expression of SSTR5.
SSTR1,5 were strongly expressed in the sweat glands in all skin biopsies.
Hair follicles and sebaceous glands expressed all five subtypes.
Striated muscle fibres showed an intense positive expression of SSTR1,4, but a weak or negative expression of SSTR5.
The wide distribution and expression pattern of all five SSTRs in human skin suggest that somatostatin is involved in the interactions between the nervous system and the skin.
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EXPERIMENTAL DERMATOLOGY, Issue 8 2005Walter Krugluger
Abstract:, Studies of human hair follicle (HF) induction by follicle-derived cells have been limited due to a lack of suitable test systems.
In this study, we established a skin organ culture system which supports HF formation by follicle-derived cells.
Long-term skin organ cultures were set up from human retroauricular skin specimens and maintained in culture for up to 8 weeks.
In vitro expanded human HF-derived cells from the dermal papilla (DP) and the outer root sheath (ORS) were injected together into the skin specimens and evaluated for their ability to induce reorganization of HFs.
Macroscopic analysis of the cultured skin specimens demonstrated the growth of velus-like hair after 4 weeks in culture.
Histologic evaluation of the cultured skin specimens after 8 weeks of culture revealed multiple miniaturized HFs with sebaceous glands.
In addition, cell clusters of various differentiation stages could be demonstrated in serial sections of the cultured skin specimens.
Labeling of HF-derived cells with the fluorescence dye CFDA-1 prior to injection suggested a de novo reorganization of HFs out of the injected cells.
In conclusion, the study demonstrated HF formation by HF-derived cells in an in vitro skin organ culture model.
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Extramammary Paget's disease,a proliferation of adnexal origin?

HISTOPATHOLOGY, Issue 6 2006S Regauer
Aim :,To investigate a possible follicular origin of extramammary Paget's disease (EPD).
EPD is a predominantly intraepidermal tumour with extensive involvement of adnexal structures and high recurrence rates suggesting a follicular stem cell origin.
Cytokeratin (CK) 15 and CK19 are considered markers for follicular stem cells located in the hair follicle bulge region.
Methods and results :,Formalin-fixed paraffin-embedded tissues of 12 cases of primary EPD (three anal, nine vulvar) were studied immunohistochemically with antibodies to CK15 and CK19.
All cases of EPD showed polygonal Paget cells in the interfollicular epidermis, hair follicles, sebaceous and apocrine glands distributed individually, in nests and in gland-like areas.
The polygonal Paget cells were intimately associated with small, flat, mitotically active, ,compressed' keratinocytes.
The large Paget cells uniformly expressed CK19 in 12/12 EPD.
The small ,compressed' keratinocytes showed strong cytoplasmic CK15 staining in 9/12 EPD with focal accentuation, while the polygonal Paget cells were negative.
Conclusions :,These histological and immunohistochemical observations allow the following conclusions: (i) the small, flat, ,compressed' keratinocytes are an integral part of EPD; (ii) the dual cell population is reminiscent of sebaceous glands with mature sebocytes and germinative keratinocytes; (iii) since both cell types express cytokeratins typical for follicular differentiation, EPD may be a proliferation of adnexal stem cells residing in the infundibulo-sebaceous unit of hair follicles and adnexal structures.
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Ciclopirox 1% shampoo for the treatment of seborrheic dermatitis

INTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 1 2006Aditya K. Gupta MD, FRCP(C)
Seborrheic dermatitis is a chronic superficial fungal infection of the skin, particularly affecting sites rich in sebaceous glands.
Although the precise etiology of seborrheic dermatitis is uncertain, yeasts of the genus Malassezia are known to play a causative role.
Ciclopirox is a broad-spectrum, hydroxypyridone-derived, synthetic antifungal agent, which also has anti-inflammatory properties.
Ciclopirox is effective both in vitro and in vivo against Malassezia yeasts, making it a valuable option for the treatment of seborrheic dermatitis.
Varying frequencies and concentrations of ciclopirox shampoo have been shown to be effective and safe in the treatment of seborrheic dermatitis of the scalp.
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Milk consumption: aggravating factor of acne and promoter of chronic diseases of Western societies

JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT, Issue 4 2009Bodo Melnik
Summary
Consumption of cow's milk and cow's milk protein result in changes of the hormonal axis of insulin, growth hormone and insulin-like growth factor-1(IGF-1) in humans.
Milk consumption raises IGF-1 serum levels in the perinatal period, adolescence and adulthood.
During puberty with the physiological onset of increased secretion of growth hormone, IGF-1 serum levels increase and are further enhanced by milk consumption.
IGF-1 is a potent mitogen; after binding to its receptor in various tissues, it induces cell proliferation and inhibits apoptosis.
Keratinocytes and sebocytes, as well as the androgen-synthesizing adrenals and gonads, are stimulated by IGF-1.
The epidemic incidence of adolescent acne in Western milk-consuming societies can be explained by the increased insulin- and IGF-1-stimulation of sebaceous glands mediated by milk consumption.
Acne can be regarded as a model for chronic Western diseases with pathologically increased IGF-1-stimulation.
Many other organs, such as the thymus, bones, all glands, and vascular smooth muscle cells as well as neurons are subject to this abnormally increased hormonal stimulation.
The milk-induced change of the IGF-1-axis most likely contributes to the development of fetal macrosomia, induction of atopy, accelerated linear growth, atherosclerosis, carcinogenesis and neurodegenerative diseases.
Observations of molecular biology are supported by epidemiologic data and unmask milk consumption as a promoter of chronic diseases of Western societies.
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Clinicopathological and immnuohistochemical findings in a series of folliculosebaceous cystic hamartoma

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 2 2009Jose M. Suarez-Peñaranda
Background:, Folliculo-sebaceous cystic hamartoma (FSCH) is an uncommon skin condition presenting as a slow-growing papulo-nodular lesion, in or around the nose.
Most cases are not clinically suspected and only histopathological examination allows the diagnosis.
Pathological features include a dermal-located infundibulo-cystic structure with sebaceous glands radiating around, a stromal component encircling the epithelial structures, with clefts between the lesional epithelial and stromal parts, as well as between this and the adjacent dermis.
Results:, We report eight patients with the diagnosis of FSCH (5 females and 3 males), with ages ranging from 35 to 77 years.
Most cases (5 out of 8) were located in or around the nose and sizes were comprised between 0.6 and 1.2 cm.
Lesions had grown for long periods of time, up to ten years in one case.
Immunohistochemistry showed staining for p63 in the epithelial component of all lesions, while CD10 was only present in some sebocytes.
CD34 and Factor XIIIa positive cells were present in the lesional stroma.
Staining for androgen and alpha-estrogen receptors was also usually noticed.
Conclusions:, FCSH is a hamartomatous skin lesion, clinically indistinct but with well-defined histopathological features.
Immunohistochemistry shows a profile very close to normal sebaceous glands.
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Expression of HuR in Merkel cell carcinoma and in normal skin

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2008Virve Koljonen
Background:, HuR is a ubiquitously expressed member of the Elav/Hu family of mRNA-binding proteins, and its cytoplasmic expression has been recognised to participate in carcinogenesis.
The aims of this study were to explore the expression pattern of HuR in primary Merkel cell carcinoma (MCC), lymph node metastases and non-neoplastic skin.
Methods:, Twenty-two primary MCC samples and five lymph node metastases were evaluated for HuR expression by immunohistochemistry.
The data were compared with clinical parameters.
Results:, Nuclear and cytoplasmic HuR-staining patterns were observed.
Nuclear immunoreactivity was observed in 91% of the primary tumors and in 80% of the lymph node metastases.
Cytoplasm was positive in 27% of the primary tumors and in 60% of the lymph node metastases.
No cytoplasmic HuR immunoreactivity was detected in non-neoplastic skin.
However, moderate to strong nuclear staining was found in normal epidermis and in the epithelium of hair follicles and sebaceous glands.
Expression of HuR in MCC did not associate with clinicopathological parameters.
Conclusions:, Primary MCCs and their lymph node metastases as well as non-neoplastic skin show nuclear expression of HuR protein.
In contrast to non-neoplastic skin, a subset of MCC tumors show cytoplasmic HuR staining, which may contribute to carcinogenesis in MCC.
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Ectopic sebaceous gland: a developmental anomaly

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 7 2006Jaime A. Tschen
This is an incidental finding in one of two biopsies from his chin, performed as part of the workup for a recalcitrant perioral acneiform eruption.
The embryogenesis and development of sebaceous glands in human scalp hair follicles are reviewed.
To our knowledge, this is the first report of such a developmental anomaly.
[source]

p63 expression in normal human epidermis and epidermal appendages and their tumors

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2003Miki Tsujita-Kyutoku
Background:, p63, a member of the p53 gene family, is expressed in basal cells of several different organs.
Methods:, The immunoreactivity of p63 was examined in normal human epidermis and epidermal appendages and their tumors, and compared with proliferative activity as evaluated by Ki-67.
Results:, In normal skin, p63 expression was seen in basal/suprabasal cells of the epidermis, outer root sheath and hair matrix cells of the hair follicle, seboblast situated in the outermost layer of sebaceous glands, and outer layer cells of the ductal portion and myoepithelial cells of the secretory portion of the sweat glands. p63 expression was confined to the cells forming a continuous basal rim along the normal epithelial structure.
In tumors, p63 expression resembled that in normal tissue in that tumor components originating from p63-positive cells were constantly positive for p63.
In normal and tumor tissues, not all p63-positive cells were positive for Ki-67.
Conclusions:, p63 expression may be a marker of basal/progenitor cells in tumors of epidermis and epidermal appendages, and may be a diagnostic marker of these tumors.
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Chloracne: histopathologic findings in one case

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 4 2002Maria Antonia Pastor
Background: Chloracne is an acneiform eruption due to poisoning by halogenated aromatic compounds having a specific molecular shape.
This condition is always a symptom of systemic poisoning by chemical chloracnegens and not just a cutaneous disorder.
Methods: We have studied a patient with severe chloracne who showed cutaneous lesions involving mostly the face and the axillae.
Results:, Histopathologic study of the facial lesions demonstrated that almost every vellus hair follicle was involved, showing a dilated infundibulum filled by a keratotic plug.
This keratotic material was mostly composed of orthokeratotic basket-weave basophilic corneocytes, namely infundibular keratin, although there were also some dilated infundibula containing eosinophilic laminated or granular sebum at their center.
Small infundibular cysts were more numerous than comedones.
Mature and well-developed sebaceous glands were seen at the base of many of the dilated infundibula and no squamous metaplasia of the sebaceous glands or ducts could be demonstrated.
Hyperpigmentation of the lesions resulted from hyperproduction of melanin by a normal number of melanocytes along the basal layer of the epidermis and infundibular epithelium.
Abundant melanin granules also impregnated the corneocytes of the infundibular plugs.
Conclusions:, Our findings support the notion that tiny infundibular cysts rather than comedones represent the basic lesions of chloracne.
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Epidermal Nevus Syndrome and Didymosis Aplasticosebacea

PEDIATRIC DERMATOLOGY, Issue 5 2007Ph.D., Zdravka Demerdjieva M.D.
The epidermal nevi are classified according to their predominant component; nevus sebaceus (sebaceous glands), nevus comedonicus (hair follicles), and nevus verrucosus (keratinocytes).
We report a neonate who presented with a nevus sebaceus on the scalp and face as well as a coloboma and dermoid on his left eye.
Within the sebaceous nevus on the scalp, circumscribed lesions of aplasia cutis congenita were detected, which is consistent with the recently proposed term in the literature didymosis aplasticosebacea.
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Ichthyosis Follicularis: A Case Report and Review of the Literature

PEDIATRIC DERMATOLOGY, Issue 1 2003Abdullah Alfadley M.D., F.R.C.P.(C.)
This report describes a child with facial dysmorphism, mental retardation, psychomotor delay, congenital alopecia of the scalp, eyebrows, and eyelashes, and extensive spiny follicular papules.
A skin biopsy specimen showed the characteristic absence of sebaceous glands.
We also reviewed the literature on this very rare entity.
Additional findings observed in our patient, including hepatosplenomegaly, undescended testicles, and ptosis, have not been reported before.
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Photodynamic therapy of facial nevus sebaceous

PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE, Issue 2 2010Hei Sung Kim
A 29-year-old man visited our department with an orange-colored patch on his right cheek.
A skin biopsy confirmed the diagnosis of nevus sebaceous.
As surgical excision was considered too destructive, photodynamic therapy (PDT) was proposed.
Sixteen sessions of PDT was performed in total.
There was a definitive but transient decrease in sebum production and destruction of the sebaceous glands.
Overall, we were not able to achieve long-lasting clinical improvement after PDT.
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Temporal triangular alopecia and a review of 52 past cases

THE JOURNAL OF DERMATOLOGY, Issue 4 2010Masashi YAMAZAKI
Abstract
Temporal triangular alopecia (TTA) is a circumscribed, non-cicatricial form of alopecia confined to the frontotemporal region.
The patient, a 15-year-old boy, was noticed at birth to have an alopecial area, sized 1.5 cm × 2.5 cm, in the right temporal region.
Microscopic examination revealed miniaturized hair follicles accompanied by differentiated sebaceous glands.
We have provided a synopsis of the past 52 cases.
Of the 53 cases of TTA including our case, more than half (55.8%) were detected in childhood between the ages of 2 and 9 years, while 36.5% were detected at birth and only 3.8% (only two cases) in adulthood.
There were three familial cases.
Several congenital diseases were associated with the condition, for example, phakomatosis pigmentovascularis, Down syndrome and Dandy,Walker malformation.
This information suggests that TTA can be recognized as a hamartomatous mosaic disease.
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Scalp dermoscopy of androgenetic alopecia in Asian people

THE JOURNAL OF DERMATOLOGY, Issue 2 2009Shigeki INUI
ABSTRACT
Although dermoscopy is used mainly for diagnosing pigmented skin lesions, this device has been reported to be useful in observing alopecia areata and frontal fibrosing alopecia.
Herein, we investigated the dermoscopic features and their incidence of androgenetic alopecia (AGA; n = 50 men) and female AGA (FAGA; n = 10 women) in Asian people.
More than 20% hair diameter diversity (HDD), which reportedly is an early sign of AGA and corresponds to hair follicle miniaturization, was observed in the affected area of all AGA and FAGA cases, suggesting that HDD is an essential feature to diagnose AGA and FAGA.
Peripilar signs, corresponding to perifollicular pigmentation, were seen in 66% (33/50) of AGA and 20% (2/10) of FAGA women.
This incidence in the present study was lower than previously reported in white subjects possibly because the Asian skin color conceals slight peripilar pigmentation.
Yellow dots were observed in 26% (13/50) of AGA and 10% (1/10) of FAGA cases and the number of yellow dots in AGA and FAGA was limited to 10 on the overall hair loss area.
Yellow dots possibly indicate the coincidence of AGA and enlargement of the sebaceous glands caused by common end-organ hypersensitivity to androgen.
In conclusion, dermoscopy is useful to diagnose AGA and FAGA and provides insights into the pathogenesis of AGA.
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Risk factors for sebaceous gland diseases and their relationship to gastrointestinal dysfunction in Han adolescents

THE JOURNAL OF DERMATOLOGY, Issue 9 2008Hong ZHANG
ABSTRACT
Sebaceous gland diseases are a group of common dermatological diseases with multiple causes.
To date, a systematic report of the risk factors for sebaceous gland diseases in adolescents has not been published.
The aim of this study was to assess the prevalence and risk factors for certain sebaceous gland diseases (seborrhea, seborrheic dermatitis, acne, androgenetic alopecia and rosacea) and their relationship to gastrointestinal dysfunction in adolescents.
From August,October, 2002,2005, a questionnaire survey was carried out to obtain epidemiological data about sebaceous gland diseases.
Using random cluster sampling, 13 215 Han adolescents aged 12,20 years were recruited from four countries or districts (Macau; Guangzhou, China; Malaysia; and Indonesia).
The statistical software SPSS ver.
13.0 was used to analyze the data.
The prevalence of seborrhea, seborrheic dermatitis, acne, androgenetic alopecia and rosacea was 28.27%, 10.17%, 51.03%, 1.65% and 0.97%, respectively.
Based on multivariate logistic regression analysis, the risk factors for sebaceous gland diseases included: age; duration of local residency; halitosis; gastric reflux; abdominal bloating; constipation; sweet food; spicy food; family history of acne; late night sleeping on a daily basis; excessive axillary, body and facial hair; excessive periareolar hair; and anxiety.
There was a statistically significant difference in the prevalence of gastrointestinal symptoms (halitosis; gastric reflux; abdominal bloating; constipation) between patients with and without sebaceous gland diseases (,2 = 150.743; P = 0.000).
Gastrointestinal dysfunction is an important risk factor for diseases of the sebaceous glands and is correlated with their occurrence and development.
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THE JOURNAL OF SEXUAL MEDICINE, Issue 3 2007Stefan Ückert PhD
ABSTRACT
Introduction., Up until now, only minimal research has been carried out on those female genital organs known to contribute to the normal cycle of sexual arousal and orgasm.
Some findings indicated that there might be a significance of cyclic nucleotide-mediated pathways in the control of the normal function of female genital tissues.
Aim., To elucidate, by means of immunohistochemistry, the distribution of the phosphodiesterase (PDE) isoenzymes 1, 3, 4, 5, 10, and 11 in the human labia minora.
Main Outcome Measures., The amount of immunohistochemical staining specific for cyclic adenosine monophosphate (cAMP)- and/or cyclic guanosine monophosphate (cGMP)-degrading PDE isoenzymes was detected.
Methods., Human labial tissue was obtained from four female cadavers (age at death: 18,42 years).
Vibratome sections prepared from formaldehyde-fixated tissue specimens were incubated with primary antibodies directed against the respective PDE isoenzymes.
Sections were then incubated with fluorochrome (fluorescein isothiocyanate, Texas Red)-labeled secondary antibodies.
Visualization was commenced by means of a laser fluorescence microscope.
Results., Immunostaining indicating the expression of PDE4 and PDE5 was abundantly observed in the smooth musculature of vessels interspersing the tissue.
Immunoreactions specific for PDE3 were recognized in epithelial and subepithelial layers, sebaceous glands, and interstitial or neuroendocrine-like single cells located in the epithelium.
Signals related to PDE10 and PDE11 were limited to the epithelium or glandular-like structures, respectively.
Conclusions., Our results, for the first time, demonstrate the presence of cAMP- and cGMP-PDE isoenzymes in the human labia minora and give a hint to a significance of PDE4 and PDE5 in the control of labial vascular tissue function. Ückert S, Oelke M, Albrecht K, Stief C, Jonas U, and Hedlund P. Immunohistochemical description of cyclic nucleotide phosphodiesterase (PDE) isoenzymes in the human labia minora.
J Sex Med 2007;4:602,608.
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Human sebocytes express prostaglandin E2 receptors EP2 and EP4 but treatment with prostaglandin E2 does not affect testosterone production

BRITISH JOURNAL OF DERMATOLOGY, Issue 3 2009W. Chen
Summary
Background, Prostaglandins (PG) play an important role in cutaneous homeostasis.
Among other skin cells, human sebocytes express cyclooxygenases and can produce PGE2.
Various prostanoid receptors have been demonstrated in epidermis and hair follicles, while limited data are available regarding their expression in sebaceous glands.
In addition, the interaction between PGE2 and androgenesis remains largely unclear.
Objectives, To examine the expression of PGE2 receptor (EP) and PGF2, receptor (FP) in human sebocytes and the influence of PGE2 or PGF2, on testosterone production.
Methods, A reverse transcription-polymerase chain reaction study was used to detect the expression of EP subtypes and FP.
A testosterone radioimmunoassay was used to measure the amount of testosterone in the supernatant of cultured SZ95 sebocytes treated with PGE2 or PGF2, alone or in the presence of various androgen precursor substrates.
Results, SZ95 sebocytes expressed mainly EP2 and EP4 but not EP3 or FP.
Testosterone production was not induced by PGE2 or PGF2,, alone or in the presence of cholesterol.
PGE2 did not affect androgenesis in cultured sebocytes.
Conclusions, The expression patterns of prostanoid receptors differ between sebocytes, hair follicles and epidermis.
The effects of PGE2 and PGF2, on the proliferation, lipogenesis and inflammation of sebocytes appear not to be associated with androgenesis.
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